Diabetes therapy : research, treatment and education of diabetes and related disordersSep 21, 2022

Use of Blood Sugar Medicines in People with Type 2 Diabetes and Heart Disease or Risk of Heart Disease

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗OA ↗

Updated Mar 19, 2026

Abstract

The percentage of patients using sodium-glucose co-transporter-2 inhibitors (SGLT-2is) among those aged ≥ 65 years with type 2 diabetes and cardiovascular disease increased from 1.1% in 2015 to 3.4% in 2019.

Utilization of SGLT-2is and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) among patients aged 50-64 years with type 2 diabetes and cardiovascular disease increased from 2015 to 2019.
In the CVD cohort aged 50-64 years, SGLT-2is usage rose from 2.6% to 7.3%, while GLP-1 RAs usage increased from 4.3% to 10.1%.
Among patients aged ≥ 65 years, utilization of GLP-1 RAs with proven cardiovascular benefit increased from 1.2% to 3.8% in the CVD cohort.
Despite these increases, overall use of SGLT-2is and GLP-1 RAs remained low across all age groups during the study period.
Similar trends were observed in the CVD risk cohort, with SGLT-2is usage among those aged 50-64 years rising from 3.3% to 6.8%.

Simplified

INTRODUCTION: There is limited published literature on longitudinal utilization of glucose-lowering agents (GLAs) among patients with type 2 diabetes (T2D) and cardiovascular disease (CVD or risk of CVD). This retrospective, observational study aimed to provide updated evidence on patient characteristics and utilization of GLAs among patients with T2D and CVD or risk of CVD in the United States.

METHODS: This was a cross-sectional evaluation of patients with T2D aged 50-89 years with annual continuous enrolment in a Medicare Advantage and Prescription Drug plan, identified from administrative claims data (Humana Research Database). Patients with T2D and atherosclerotic cardiovascular disease (ASCVD) or heart failure (HF) (CVD cohort), or T2D and an additional CVD risk factor without pre-existing CVD (CVD risk cohort) were identified from 2015 to 2019. Patients were followed from their first observed ASCVD/HF diagnosis or CVD risk factor for each year they were continuously enrolled or until occurrence of a CVD diagnosis (CVD risk cohort only). Use of GLA classes were reported by year, cohort, and age groups (50-64 years and ≥ 65 years).

RESULTS: The percentage of patients on sodium-glucose co-transporter-2 inhibitors (SGLT-2is), glucagon-like peptide-1 receptor agonists (GLP-1 RAs), and GLP-1 RAs with proven cardiovascular benefit, respectively, increased from 2015 to 2019 among ≥ 65 years (CVD cohort: 1.1-3.4%, 1.6-4.0%, and 1.2-3.8%; CVD risk cohort: 1.4-3.7%, 2.0-4.3%, and 1.5-4.1%); and among 50-64 years (CVD cohort: 2.6-7.3%, 4.3-10.1%, and 3.4-9.4%; CVD risk cohort: 3.3-6.8%, 4.6-9.6%, and 3.5-8.9%).

CONCLUSIONS: Although use of SGLT-2is and GLP-1 RAs increased over time, overall utilization of these agents in patients with T2D and ASCVD/HF or at risk for ASCVD/HF remained low, especially for those aged ≥ 65 years.

Key numbers

3.4%

Increase in SGLT-2 Inhibitor Use (≥ 65 years)

Percentage of patients aged ≥ 65 years with CVD using SGLT-2 inhibitors in 2019.

7.3%

Increase in SGLT-2 Inhibitor Use (50-64 years)

Percentage of patients aged 50-64 years with CVD using SGLT-2 inhibitors in 2019.

1.1-3.4%

Low Overall Utilization of GLAs (≥ 65 years)

Percentage range of patients aged ≥ 65 years using GLAs with proven cardiovascular benefits from 2015 to 2019.

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Use of Blood Sugar Medicines in People with Type 2 Diabetes and Heart Disease or Risk of Heart Disease

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